IGRA、LAM抗体联合Xpert技术检测对膝关节结核的诊断价值及与结核活动性的关系

Values of IGRA and LAM Antibody Combined with Xpert Technology Detection in Diagnosis of Knee-joint Tuberculosis and Their Relationships with Tuberculosis Activity

目的探究γ-干扰素(IFN-γ)释放水平、脂阿拉伯甘露糖(LAM)抗体联合Xpert技术检测对膝关节结核的诊断价值及与结核活动性的关系。方法选取2018年1月—2021年1月66例膝关节结核作为研究组,另选取同期66例非结核性膝关节病变作为对照组。比较两组IFN-γ释放水平、LAM抗体和Xpert阳性率,分析三者之间的关系及对膝关节结核的诊断价值。比较活动性与非活动性膝关节结核患者IFN-γ释放水平、LAM抗体和Xpert阳性率,并分析三者与结核活动性的关系。结果研究组IFN-γ释放水平、LAM抗体和Xpert阳性率均较对照组高(P<0.01)。研究组IFN-γ释放水平、LAM抗体和Xpert阳性率间均呈正相关(P<0.01)。IFN-γ释放水平、LAM抗体、Xpert技术及三者联合诊断膝关节结核的曲线下面积分别为0.851、0.818、0.864及0.904。活动性膝关节结核患者IFN-γ释放水平、LAM抗体和Xpert阳性率均较非活动性膝关节结核患者高(P<0.01)。IFN-γ释放水平、LAM抗体和Xpert阳性率均与结核活动性呈正相关(P<0.01)。结论IFN-γ释放水平、LAM抗体联合Xpert技术检测可为临床诊断膝关节结核提供参考,且能反映结核活动性。

Objective To explore values of interferon-γ(IFN-γ)release level,lipoarabinomannan(LAM)antibody combined with Xpert technology detection in diagnosis of knee-joint tuberculosis and their relationships with tuberculosis activity.Methods A total of 66 patients with knee-joint tuberculosis between January 2018 and January 2021 were selected as research group,and other 66 patients with non-knee-joint tuberculosis at the same period were selected as control group.In two groups,IFN-γrelease level,and positive rates of LAM antibody and Xpert were compared,and relationships among the three indexes and their values in diagnosis of knee-joint tuberculosis were analyzed.IFN-γrelease level,positive rates of LAM antibody and Xpert were compared between patients with active and inactive knee-joint tuberculosis,and the relationships among the three indexes with tuberculosis activity were analyzed.Results In research group,IFN-γrelease level,positive rates of LAM antibody and Xpert were significantly higher than those in control group(P<0.01),and there were positive correlations among IFN-γrelease level,and positive rates of LAM antibody and Xpert(P<0.01).The areas under the receiver operating characteristic(ROC)curve of IFN-γrelease level,LAM antibody,Xpert technology and the combined detection of the three indexes in diagnosis of knee-joint tuberculosis were 0.851,0.818,0.864 and 0.904 respectively.IFN-γrelease levels,and positive rates of LAM antibody and Xpert in patients with active knee-joint tuberculosis were significantly higher than those with inactive knee-joint tuberculosis(P<0.01).IFN-γrelease level,positive rates of LAM antibody and Xpert were all positively correlated with tuberculosis activity(P<0.01).Conclusion The detection of IFN-γrelease level,LAM antibody combined with Xpert technology may provide reference for clinical diagnosis of knee-joint tuberculosis,which can reflect tuberculosis activity.